Active NPI
Sherri Koning
- Occupational Therapist
- Jacksonville Beach, FL
National Provider Identifier
1245513175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0881
- Practice address
- 333 1St St N
Suite 200
Jacksonville Beach, FL 32250-6945 - Phone
- (866) 301-5038
- Fax
- (888) 711-5039
- NPI assigned
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0881 | NV | Primary |
| Occupational Therapist | 225X00000X | OT-722 | ID |
Addresses
Primary practice location
333 1St St N
Suite 200
Jacksonville Beach, FL 32250-6945
Mailing address
4370 Schindler Rd
Fallon, NV 89406-7297
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-722 | ID | MD | Occupational Therapist |
| 0881 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1245513175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4370 SCHINDLER RD",
"city": "FALLON",
"state": "NV",
"postal_code": "894067297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 1ST ST N",
"address_2": "SUITE 200",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322506945",
"telephone_number": "866-301-5038",
"fax_number": "888-711-5039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONING",
"first_name": "SHERRI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-27",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "0881",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-722",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.